23例恶性黑色素瘤小肠转移临床病例分析

摘要

To investigate the clinical characteristics of metastatic malignant melanoma of the small bowel. Methods:One case was from our hospital,the others were from online search of CNKI medical database,Wan-fang Data and American NCBI Pubmed database between 1979 and 2012 by using of " malignant melanoma,small bowel,small intestine,metastasis" . The general conditions,primary site of melanoma,interval between treatment of the first melanoma and detection of metastasis and symptoms/ signs were collected from all the 23 cases. Results:The 23 patients comprised 14 males and 9 females. The mean age at metastasis was 54. 7 years. The mean interval between di-agnosis of the first melanoma and detection of metastasis was 6. 33 years(0 to 20 years). The common symptoms were abdominal pain(69. 6% )and GI bleeding(30. 4% ). 60. 9% patients developed intestinal obstruction or intussus-ceptions. The mean diameter of tumor size was 5. 82cm(2 - 15cm). 47. 8% patients had multiple metastases. Conclu-sion:Metastatic malignant melanoma of the small bowel was susceptible to develop intestinal obstruction or intussus-ceptions. The common presenting symptoms were abdominal pain and GI bleeding. Half of patients had multiple metas-tases. And the interval between treatment of the first melanoma and detection of metastasis was usually long.%目的：总结恶性黑色素瘤小肠转移的临床病例特点。方法：我院诊治1例，通过中国知网、万方医学网以及 MEDLINE（或 PUBMED）检索到国内外报道的黑色素瘤小肠转移病例共23例，并进行统计分析。收集一般情况、黑色素瘤原发部位、原发肿瘤至小肠转移间隔时间以及临床症状等。结果：23例（男14例，女9例），平均年龄54.7岁，初次诊断至发现转移平均时间间隔为6.33年（0-20年）。主要临床表现为腹痛16例（69.6%），黑便/便血7例（30.4%），肠梗阻或肠套叠14例（60.9%）。肿瘤最大直径平均为5.82cm（2-15cm）。47.8%为小肠多发转移。结论：恶性黑色素瘤小肠转移主要临床表现为腹痛、黑便，易于发生肠梗阻或肠套叠；肿瘤常多发转移，且发现小肠转移距初次诊断时间间隔较长。